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Related Concept Videos

Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Aortic Regurgitation III: Medical Management01:25

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Aortic Regurgitation IV: Nursing Management01:17

Aortic Regurgitation IV: Nursing Management

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A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
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Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

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Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
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Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
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Reduced Longitudinal Function in Chronic Aortic Regurgitation.

Steven J Lavine1, Kais A Al Balbissi1

  • 1Division of Cardiology, Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA.

Journal of Cardiovascular Ultrasound
|January 13, 2016
PubMed
Summary
This summary is machine-generated.

Chronic aortic regurgitation (AR) impairs global longitudinal function even with preserved ejection fraction (EF). This study shows reduced strain and altered diastolic function in AR patients, highlighting the need for early detection of cardiac dysfunction.

Keywords:
Aortic valve insufficiencyLeft ventricular functionLeft ventricular remodeling

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Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Physiology

Background:

  • Chronic aortic regurgitation (AR) leads to left ventricular (LV) remodeling, increasing mass and volume.
  • Patients with chronic AR may maintain a preserved LV ejection fraction (EF) despite underlying cardiac changes.

Purpose of the Study:

  • To investigate whether global longitudinal systolic and diastolic function are reduced in chronic AR patients with preserved LV EF.
  • To compare cardiac function in AR patients with preserved EF (AR + PEF) to those with reduced EF (AR + REF) and hypertensive heart disease.

Main Methods:

  • Doppler echocardiography was used to assess 27 normal subjects, 87 AR + PEF patients, 66 AR + REF patients, and 82 hypertensive heart disease patients.
  • Measurements included LV volume, transmitral spectral and tissue Doppler, myocardial velocities, timing, and longitudinal strain from apical views.

Main Results:

  • Global longitudinal strain was significantly reduced in both AR + PEF (13.8 ± 4.0%) and AR + REF (11.4 ± 4.7%) compared to normals (18.4 ± 3.6%).
  • Average peak diastolic annular velocity (e') was decreased, and peak rapid filling velocity/e' (E/e') was increased in both AR groups, indicating impaired diastolic function.
  • Global longitudinal strain correlated with EF, E/e', and tricuspid regurgitation velocity.

Conclusions:

  • Chronic AR is associated with impaired longitudinal cardiac function, even when EF is preserved.
  • Global longitudinal strain is a valuable indicator, correlating well with noninvasive estimates of LV filling pressures and pulmonary systolic arterial pressures in AR.